Healthcare Provider Details

I. General information

NPI: 1245037548
Provider Name (Legal Business Name): SRG HEALTH LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/25/2025
Last Update Date: 02/25/2025
Certification Date: 02/25/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

18540 W 9 MILE RD
SOUTHFIELD MI
48075-4023
US

IV. Provider business mailing address

18540 W 9 MILE RD
SOUTHFIELD MI
48075-4023
US

V. Phone/Fax

Practice location:
  • Phone: 248-770-9926
  • Fax:
Mailing address:
  • Phone: 248-770-9926
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code3747P1801X
TaxonomyPersonal Care Attendant
License Number
License Number State

VIII. Authorized Official

Name: OMAR ATCHO
Title or Position: OWNER
Credential:
Phone: 248-770-9926